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Pheochromocytoma: Causes and Risk Factors

Pheochromocytoma is a rare tumor that grows in the adrenal glands and releases hormones that cause high blood pressure. Symptoms include headaches, sweating, anxiety, and palpitations. While most tumors are benign, 10-15% are cancerous. Genetic disorders increase risk. Diagnosis involves blood, urine, MRI or CT scans. Surgery to remove the tumor or affected adrenal gland is usually required, along with monitoring after to ensure the tumor does not recur. Long term follow up of blood pressure and catecholamine levels is important for patient care and screening for recurrence.

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Johanna Recca Marino
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56 views4 pages

Pheochromocytoma: Causes and Risk Factors

Pheochromocytoma is a rare tumor that grows in the adrenal glands and releases hormones that cause high blood pressure. Symptoms include headaches, sweating, anxiety, and palpitations. While most tumors are benign, 10-15% are cancerous. Genetic disorders increase risk. Diagnosis involves blood, urine, MRI or CT scans. Surgery to remove the tumor or affected adrenal gland is usually required, along with monitoring after to ensure the tumor does not recur. Long term follow up of blood pressure and catecholamine levels is important for patient care and screening for recurrence.

Uploaded by

Johanna Recca Marino
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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PHEOCHROMOCYTOMA

INTRODUCTION
A pheochromocytoma (PCC) is a rare
tumor that usually grows in your adrenal
glands, above your kidneys. It’s also
known as an adrenal paraganglioma or
a chromaffin cell tumor.
It’s most common in adults ages 30 to
50, but people of all ages can have it.
Children make up about 10% of all
cases.
Your adrenal glands make hormones
that control things like
your metabolism and blood pressure. A
pheochromocytoma also releases
hormones, at much higher levels than
usual. These extra hormones cause
high blood pressure, which can damage
your heart, brain, lungs, and kidneys.
About 10% to 15% of these tumors are
cancerous, and they can spread to
other parts of your body. But most
pheochromocytoma tumors are benign, meaning they’re not cancerous.

CAUSES AND RISK FACTORS


Doctors don’t know why most PCC tumors form.
About 30% of cases seem to run in families. These are more likely to be cancerous than ones that
appear at random.
The tumors are more common in people who have disorders or conditions that are passed down
from parents to children, including:

 Multiple endocrine neoplasia, type II


 Von Hippel-Lindau disease
 Neurofibromatosis 1 (NF1)
 Hereditary paraganglioma syndrome
SIGNS AND SYMPTOMS

Some people with these tumors have high blood pressure all the time. For others, it
goes up and down.

That may be your only sign of a problem. But most people have at least one other
symptom, including:

 Constipation
 Dizziness when standing
 Nausea
 Tremors
 Shortness of breath
 Pale skin
 Fast or uneven heartbeat (heart palpitations)
 Severe headache
 Stomach, side, or back pain
 Unusual sweating
 Vomiting
 Weight loss
 Weakness
 Anxiety attacks

PATHOPHYSIOLOGY
DIAGNOSIS

Many people who have pheochromocytoma are never diagnosed because the
symptoms are so much like those of other conditions. Some tests can tell your doctor if
you have it:

 Blood or urine tests to look for high levels of hormones


 An MRI (magnetic resonance imaging) scan, which uses powerful magnets and
radio waves to make images of organs and tissues to check for a tumor
 A CT scan, which puts together several X-rays taken from different angles to spot
a tumor

If you have PCC, you might have tests to see if it was caused by a problem with your
genes. This can tell you if you’re more likely to get another tumor and whether your
family members are at higher risk.

MEDICAL MANAGEMENT
You’ll most likely need surgery to remove the tumor. Your doctor may be able to do this using
tiny cuts instead of one large opening. This is called laparoscopic or minimally invasive surgery.
You generally recover faster from those procedures than from traditional surgery.
Before the surgery, you may need to take medication to lower your blood pressure and control an
occasional fast heart rate.
If you have a tumor in only one adrenal gland, your doctor will probably remove that whole
gland. The other gland will make the hormones your body needs.
If you have tumors in both glands, your surgeon may remove just the tumors and leave part of
the glands.
If your tumor is cancerous, you may also have radiation, chemotherapy, or targeted therapy
(using drugs to attack specific cancer cells) to help keep it from growing.

NURSING MANAGEMENT

The patient who has undergone surgery to treat pheochromocy-toma has experienced a
stressful preoperative and postoperative course and may remain fearful of repeated
attacks. Although it is usually expected that all pheochromocytoma tissue has been re-
moved, there is a possibility that other sites were undetected and that attacks may
recur. The patient is monitored for several days in the intensive care unit with special
attention given to ECG changes, arterial pressures, fluid and electrolyte balance, and
blood glucose levels. Several intravenous lines are inserted for administration of fluids
and medications.
 

PROMOTING HOME AND COMMUNITY-BASED CARE

Teaching Patients Self-Care. 

During the preoperative and post-operative phases of care, the nurse informs the
patient about the importance of follow-up monitoring to ensure that pheochro-mocytoma
does not recur undetected. After adrenalectomy, use of corticosteroids may be needed.
Therefore, the nurse instructs the patient about their purpose, the medication schedule,
and the risks of skipping doses or stopping their administration abruptly.

It is important to teach the patient and family how to measure the patient’s blood
pressure and when to notify the physician about changes in blood pressure.
Additionally, the nurse provides verbal and written instructions about the procedure for
collecting 24-hour urine specimens to monitor urine catecholamine levels

Continuing Care.

A follow-up visit from a home care nurse maybe indicated to assess the patient’s
postoperative recovery, surgi-cal incision, and compliance with the medication
schedule. This may help to reinforce previous teaching about management and
monitoring. The home care nurse also obtains blood pres-sure measurements and
assists the patient in preventing or deal-ing with problems that may result from long-
term use of corticosteroids.

Because of the risk of recurrence of hypertension, periodic checkups are required,


especially in young patients and in pa-tients whose families have a history of
pheochromocytoma. The patient is scheduled for periodic follow-up appointments to ob-
serve for return of normal blood pressure and plasma and urine levels of
catecholamines.

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